South Carolina Licensed RN Medical Reviewer
Job Summary
Acting as a team leader for specialty programs, the full-time South Carolina Licensed RN Medical Reviewer will provide guidance and training to staff in medical review, utilization management, and case management while working remotely with occasional on-site requirements for training and meetings.
Key responsibilities
- Lead and mentor staff in medical review processes and ensure adherence to quality standards
- Monitor workflow and workloads, reallocating tasks as necessary to meet deadlines
- Engage in departmental quality reviews and oversee compliance initiatives and special projects
Required qualifications
- Associate's degree in a job-related field or graduate of an accredited School of Nursing
- Four years of clinical experience, or a combination of two years clinical and two years medical review/utilization review experience
- Active, unrestricted RN licensure in South Carolina or a compact multistate RN license
- Strong clinical experience in home health, rehabilitation, or broad medical-surgical settings
- Proficiency in Microsoft Office applications
Complete Job Description
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